Category Archives: Smoking Cessation

London hospitals to replace doctors and nurses with AI for some tasks

One of the country’s biggest hospitals has unveiled sweeping plans to use artificial intelligence to carry out tasks traditionally performed by doctors and nurses, from diagnosing cancer on CT scans to deciding which A&E patients are seen first.

The three-year partnership between University College London Hospitals (UCLH) and the Alan Turing Institute aims to bring the benefits of the machine learning revolution to the NHS on an unprecedented scale.

Prof Bryan Williams, director of research at University College London Hospitals NHS Foundation Trust, said that the move could have a major impact on patient outcomes, drawing parallels with the transformation of the consumer experience by companies such as Amazon and Google.

“It’s going to be a game-changer,” he said. “You can go on your phone and book an airline ticket, decide what movies you’re going to watch or order a pizza … it’s all about AI,” he said. “On the NHS, we’re nowhere near sophisticated enough. We’re still sending letters out, which is extraordinary.”

At the heart of the partnership, in which UCLH is investing a “substantial” but unnamed sum, is the belief that machine learning algorithms can provide new ways of diagnosing disease, identifying people at risk of illness and directing resources. In theory, doctors and nurses could be responsively deployed on wards, like Uber drivers gravitating to locations with the highest demand at certain times of day. But the move will also trigger concerns about privacy, cyber security and the shifting role of health professionals.

The first project will focus on improving the hospital’s accident and emergency department, which like many hospitals is failing to meet government waiting time targets.

“Our performance this year has fallen short of the four-hour wait, which is no reflection on the dedication and commitment of our staff,” said Prof Marcel Levi, UCLH chief executive. “[It’s] an indicator of some of the other things in the entire chain concerning the flow of acute patients in and out the hospital that are wrong.”

In March, just 76.4% of patients needing urgent care were treated within four hours at hospital A&E units in England in March – the lowest proportion since records began in 2010.

Using data taken from thousands of presentations, a machine learning algorithm might indicate, for instance, whether a patient with abdomen pain was likely to be suffering from a severe problem, like intestinal perforation or a systemic infection, and fast-track those patients preventing their condition from becoming critical.

“Machines will never replace doctors, but the use of data, expertise and technology can radically change how we manage our services – for the better,” said Levi.

Another project, already underway, aims to identify patients who are are likely to fail to attend appointments. A consultant neurologist at the hospital, Parashkev Nachev, has used data including factors such as age, address and weather conditions to predict with 85% accuracy whether a patient will turn up for outpatient clinics and MRI scans.

In the next phase, the department will trial interventions, such as sending reminder texts and allocating appointments to maximise chances of attendance.

“We’re going to test how well it goes,” said Williams. “Companies use this stuff to predict human behaviour all the time.”

Other projects include applying machine learning to the analysis of the CT scans of 25,000 former smokers who are being recruited as part of a research project and looking at whether the assessment of cervical smear tests can be automated. “There are people who have to look at those all day to see if it looks normal or abnormal,” said Williams.

Might staff resent ceding certain duties to computers – or even taking instructions from them? Prof Chris Holmes, director for health at the Alan Turing Institute, said the hope is that doctors and nurses will be freed up to spend more time with patients. “We want to take out the more mundane stuff which is purely information driven and allow time for things the human expert is best at,” he said.

When implementing new decision-making tools, the hospital will need to guard against “learned helplessness”, where people become so reliant on automated instructions that they abandon common sense. While an algorithm might be correct 99.9% of the time, according to Holmes, “once in a blue moon it makes a howler”. “You want to quantify the risk of that,” he added.

UCLH is aiming to circumvent privacy concerns that have overshadowed previous collaborations, including that of the Royal Free Hospital in London and Google’s DeepMind, in which the hospital inadvertently shared the health records of 1.6 million identifiable patients. Under the new partnership, algorithms will be trained on the hospital’s own servers to avoid any such breaches and private companies will not be involved, according to Holmes.

“We’re critically aware of patient sensitivity of data governance,” he said. “Any algorithms we develop will be purely in-house.”

Questions also remain about the day-to-day reality of integrating sophisticated AI software with hospital IT systems, which are already criticised for being clunky and outdated. And there will be concerns about whether the move to transfer decision-making powers to algorithms would make hospitals even more vulnerable to cyber attacks. Hospital IT systems were brought to a standstill last year after becoming victim to a global ransomware attack that resulted in operations being cancelled, ambulances being diverted and patient records being unavailable.

Williams acknowledged that adapting NHS IT systems would be a challenge, but added “if this works and we demonstrate we can dramatically change efficiency, the NHS will have to adapt.”

Critically ill ‘should not be made to die away from home’

One in three people who die in hospital could spend their final days at home if the government introduces and adequately funds a modern community-based health and social care system, a new report says.

The Institute for Public Policy Research (IPPR) says that, while most people would prefer to die at home or in a good care home, they are often unable to do so because of inadequate and underfunded local care.

The researchers analysed investment in long-term care in several European countries, and concluded that there appears to be a correlation between funding levels, modern systems and the proportion of people dying in hospitals. Citing 2017 data from the Survey of Health, Ageing and Retirement in Europe, covering 28 countries, IPPR found the proportion of people dying in hospital in England (47%) was higher than in many EU states, with people dying at home (23%) the second lowest after Sweden and the Czech Republic (22%).

An elderly woman is tucked into bed at home by a care assistant


‘Enabling more people to spend their last days outside hospitals, in more appropriate settings, with properly funded support, will improve their experience of care,’ said IPPR research fellow Jack Hunter. Photograph: Gary John Norman/Getty/Cultura RF

If funding were increased to match that in countries with the lowest rates of deaths in hospitals and the most up-to-date systems – such as the Netherlands – IPPR argues, up to a third of those who currently die in hospital could be at home or in a care setting. Data for England cited in the report also shows marked regional variations, with more people dying in hospital in poorer areas. While 49% died in hospital in the north-west and West Midlands, the proportion was 43% in the south-east.

“Taken together,” the report says, “the variation in hospital deaths between European countries and within England suggests there is significant scope for policy to reduce the proportion of people who spend their final days in hospital, and in doing so potentially develop a model for end-of-life care that is of higher quality and lower net cost to the taxpayer.”

Around 60% of those who reported poor care experienced it in a hospital, and most say they would prefer to be at home, given adequate services.

IPPR research fellow Jack Hunter said: “For too many, the end of life is an even more difficult experience than it needs to be. The fact that those in the most deprived areas are more likely to die in hospital is wholly unjust. Where you live should not affect whether you experience good-quality care at the end of your life.

“Enabling more people to spend their last days outside hospitals, in more appropriate settings, with properly funded support, will improve their experience of care. It will also be more cost-effective for the taxpayer.”

A green paper on care and support for older people is due to be published this summer. In last January’s cabinet reshuffle, Jeremy Hunt kept his health portfolio, but his responsibilities and title were expanded to include social care. This was a signal of long-promised reform, merging the health and care budgets and systems.

The report calls for more power to be devolved to local authorities and for a big cash injection. But it concludes: “It is far from clear that the government’s vision will include the size and scale of investment for care that would be commensurate with a radical shift in funding, nor whether it will also consider long-term options (including devolved fiscal measures) to ensure the long-term sustainability of local authorities.”

47%

Proportion of people in England who died in hospital .

23%

Proportion of people in England who died at home.

£487

Estimated public saving, per person, of shifting care, in final three months of life, from hospital to community.

NHS warns patients they could lose text alerts as GDPR deluge continues

The National Health Service is texting patients to warn they could lose alerts about hospital and doctor appointments, joining the deluge of more than 1bn “GDPR” messages currently hitting personal inboxes to meet an EU deadline this week.

GDPR, which stands for General Data Protection Regulation, has been described as the biggest overhaul of online privacy since the birth of the internet, and comes into force on Friday May 25. It gives all EU citizens the right to know what data is stored on them and to have it deleted, plus protect them from privacy and data breaches. If companies fail to comply, they can be hit with fines of up to €20m (£17.5m) or 4% of global turnover.

Companies and organisations around the world – from giant corporations to charities and church groups – are now anxiously contacting users to check they are happy to carry on receiving their emails and texts.

Q&A

What is GDPR?

The European Union’s new stronger, unified data protection laws, the General Data Protection Regulation (GDPR), will come into force on 25 May 2018, after more than six years in the making.

GDPR will replace the current patchwork of national data protection laws, give data regulators greater powers to fine, make it easier for companies with a “one-stop-shop” for operating across the whole of the EU, and create a new pan-European data regulator called the European Data Protection Board.

The new laws govern the processing and storage of EU citizens’ data, both that given to and observed by companies about people, whether or not the company has operations in the EU. They state that data protection should be both by design and default in any operation.

GDPR will refine and enshrine the “right to be forgotten” laws as the “right to erasure”, and give EU citizens the right to data portability, meaning they can take data from one organisation and give it to another. It will also bolster the requirement for explicit and informed consent before data is processed, and ensure that it can be withdrawn at any time.

To ensure companies comply, GDPR also gives data regulators the power to fine up to €20m or 4% of annual global turnover, which is several orders of magnitude larger than previous possible fines. Data breaches must be reported within 72 hours to a data regulator, and affected individuals must be notified unless the data stolen is unreadable, ie strongly encrypted.

Each person in the UK is understood to have about 100 “data relationships” and with many companies sending out multiple reminders, the total number of GDPR emails is expected to soar above one billion by this Friday.

But with GDPR fatigue setting in, and with many messages heading straight into spam boxes, the figures suggest that few people are responding.

Polling by consultancy Accenture has found that more than half of consumers are not responding to emails from brands, with about a third of people deleting the emails almost as soon as they arrive in their inbox.

Some small businesses are reporting that “reconfirmation” rates are averaging just 10%, meaning they are losing 90% of their marketing email lists.

“Up to the deadline you are going to continue to see some panic and mass communications. Then there will be a lull before it begins again, as this is an ongoing requirement,” said Russell Marsh of Accenture. He is forecasting that some companies will return to direct mail to target customers, as it does not fall under the same GDPR legislation.

Many people are enjoying a once in a lifetime opportunity to clear out their inboxes. But while many can be safely ignored, others – such as from the NHS – will need action.

The NHS message reads: “The law is changing and we must get explicit permissions from patients when using their data. To continue to receive SMS text messages, reply START.”

The messages are being sent from the NHS automated appointment reminder system, used by millions of people across the UK. Data rules mean that the messages are sent by each individual NHS trust rather than centrally from the NHS.

Companies are handling the new rules in different ways, as there is no prescribed format for GDPR approval. If a company has a “legitimate interest” in contacting a customer – such as their principal bank account – then it only needs to let the customer know that privacy details have been updated.

But if the email address had been obtained in other ways – such as a pre-ticked box – then that is not regarded as legitimate, and the company has to contact the consumer and obtain approval for further communications. Some companies are insisting users go through the rigmarole of logging in, which might entail trying to remember a password or setting up a new account.

“It will be their interpretation of what they need to do to be compliant,” said Robert Parker at the UK’s Information Commissioner’s Office.

Companies are resorting to ever more desperate ways to catch the eye of users in inboxes deluged with GDPR emails. Many are in the plaintive “Do you still want to hear from us?” style, others warn that “Time is running out”, while some demand “Urgent action required”. Or as one flower delivery company GDPR email says: “Take it or leaf it”.

Like Tessa Jowell, I have a brain tumour. I hope her death inspires new research | Jessica Morris

Many people are grieving the untimely death of Tessa Jowell. She was an exceptional person. Tony Blair confirmed the impression she gave to those of us who only knew her from afar: “Tessa had passion, determination and simple human decency in greater measure than any person I have ever known.”

For me, her death is personal for another reason. We found ourselves in the same elite club.

Like Tessa Jowell, I was blindsided by a diagnosis of glioblastoma (GBM) in January 2016. I was walking in the hills in upstate New York (we live in the city) when a strange sensation made me stop. I opened my mouth to explain to my friends and found I couldn’t form any words. I slumped into unconsciousness, having a full-blown seizure.

Two days later I had brain surgery, and the terrible diagnosis came two weeks after that. Now, more than two years later, I am determined to do what I can to improve the outcomes for everyone like me living with this brutal disease. Jowell’s death gives me added impetus in the struggle to turn this monstrous disease around.

After I was diagnosed, I asked my neuro-oncologist why glioblastoma is so deadly; why the terrifying statistics suggested that I had a mere 5% chance of surviving five years. He explained to me that the dreaded figure five also relates to another key statistic: the percentage of successful applications for research funding into GBM. This disease is so complex, so aggressive and so rare, that it is hard to attract substantial research funding.

It is especially gratifying that Jowell’s powerful legacy has already begun to be felt in the form of increased government funding. But she would be the first to agree this is not enough. There is another currency to tap: a goldmine of patient-generated data that is massively under-collected and undervalued. At the heart of every GBM drama, as with any life-threatening disease, is a human being enduring symptoms – some good, many bad – resulting from the cancer and the treatments we take. Yet our relationship as patients with our disease is not consistently recorded or analysed. It can feel as if, from the perspective of the medical system, our experience is not worth understanding.

Tessa Jowell dies aged 70 – video obituary

As an example, I’ve been fortunate enough to be treated in New York with ground-breaking treatments that can be hard to come by in the UK, including electrotherapy and immunotherapy. These cost more than $ 30,000 a month, covered by insurance and the drug company’s compassionate use programme. But how the interaction between these therapies is actually affecting me is not recorded. This reflects a long-standing approach in medicine. The “objective” measures of disease progression, as evidenced by things like the size of my tumour, the results of my MRIs, are prized. The “subjective” measures of my experience – how I feel each day, my personal responses in terms of X or Y – are largely ignored.

Patients are active, wanting to share and swap notes. Desperate to know whether a change in diet, or a cocktail of supplements, or exercise, or mindset, can help them stay alive, they are busy on social media. Amid all this noise, doctors have little advice to give – “Should I adopt the ketogenic diet? Take medical marijuana? Fast twice a week?” – because none of these approaches have been, or could be, subject to the kind of clinical trial a new drug treatment undergoes.

But imagine if we could ask people to log how they’re feeling, and what steps they’re taking to manage their disease, every day. Imagine if we could then aggregate all that data and mine it for insights. Couldn’t we find some clues from patients’ unfiltered perspective that would supplement the clinical trials information?

Dr Ethan Basch, of the Lineberger Comprehensive Cancer Center, University of North Carolina, undertook some fascinating research last year. He found that if you ask someone with cancer to log their symptoms, the act of doing so, coupled with your clinician’s ability to adjust therapies in real time, can lead to an actual improvement in disease outcome. People lived longer.

I’ve channelled my own frustration with my diagnosis into creating OurBrainBank, a non-profit organisation designed to move glioblastoma from terminal to treatable, powered by patients. We recently launched our pilot app in the US. People with GBM can log their symptoms daily and their aggregated data will be available to any qualified GBM researcher worldwide, for free, subject to strict screening. People using the app report feeling more on top of their disease through daily monitoring; better able to make use of their meetings with their clinicians; and more hopeful that by sharing their personal data they can play an active role in making progress.

Tessa Jowell died during May, which happens to be brain tumour awareness month. Our colour is grey. It’s strangely apt. Because what we need to crack GBM is to use our grey cells to think creatively and empathetically – patient and doctor alike.

That’s the kind of approach she espoused. She put it the best: “I hope always my politics are the politics of aspiration, ambition, possibility and the future.”

Jessica Morris is a strategic communications consultant and the founder and chair of OurBrainBank

Failure to act against ‘dangerous’ midwives resulted in deaths – report

Babies and mothers died after a health regulator failed to act against midwives suspected of providing dangerously poor care, despite the police raising concerns about their conduct, a damning report has concluded.

The Nursing and Midwifery Council (NMC) did nothing for two years about information supplied by Cumbria police on maternity staff at Furness general hospital, an inquiry found.

The NMC’s failure to instigate disciplinary proceedings against midwives at the hospital allowed them to carry on practising when they represented a danger to pregnant women and their offspring, according to the Professional Standards Authority (PSA).

Up to 19 babies and mothers died at the hospital between 2004 and 2012 as a result of mistakes by staff of its maternity unit, in one of the biggest patient care scandals involving an NHS trust in England.

A previous inquiry into the deaths concluded that 13 of the infants and women would have lived if they had received better care. The scandal involved six neonatal deaths, 10 stillbirths and three deaths of mothers at the hospital, which is one of five run by Morecambe Bay hospitals NHS foundation trust.

The PSA’s review of the NMC’s handling of the scandal was commissioned by the health secretary, Jeremy Hunt. Cumbria police told the review: “We were really concerned that reports of the same midwives [of whom] we had the cases sitting in front of us were still practising at the hospital.”

The PSA, which supervises medical regulators, found that the NMC was not prompted to do anything by the police reports, despite their seriousness.

“In our view there was scope for the NMC to investigate the wider fitness to practise of the midwives concerned and the police expected them to do so at the time the information was sent,” the 80-page report says. “We saw no evidence that the NMC considered doing so. This was an opportunity missed, given that some of the midwives identified by the police were subsequently involved in adverse events at [Furness general hospital].”

The NMC has admitted that its handling of cases involving midwives from the trust was unacceptable and has said it is “truly sorry”. Jackie Smith, the regulator’s chief executive since 2012, announced her resignation on Monday.

Bill Kirkup, who led the inquiry into the scandal that reported in 2015, has criticised the NMC’s “lamentable failure” over its decision to clear two midwives of misconduct relating to the death in 2008 of Joshua Titcombe. He died nine days after his birth after midwives failed to spot he had a serious infection.

In a scathing joint statement, Joshua’s father, James Titcombe, and two other bereaved parents, Liza Brady and Carl Hendrickson, said the report exposed “the truly shocking scale of the NMC’s failure to respond properly to the serious concerns and detailed information provided to them”.

They said: “We were particularly horrified that even when Cumbria police directly raised significant issues, the NMC effectively ignored the information for almost two years. Whilst this was going on, serious incidents involving registrants [midwives] under investigation continued, meaning lives were undoubtedly put at risk. Avoidable tragedies continued to happen that could well have been prevented.”

They also slated the NMC for being “defensive, legalistic and in some cases grossly misleading in their responses to families and others” and for its “culture of denial and reputational management”.

The PSA’s report also reveals that the NMC mishandled its dealings with bereaved families, had very poor record-keeping and did not pass on to the PSA material that the latter’s inquiry team then found elsewhere.

Smith, the outgoing chief executive, said: “Since 2014 we’ve made significant changes to improve the way we work and as the report recognises, we’re now a very different organisation. The changes we’ve made put vulnerable witnesses and families affected by failings in care at the heart of our work. But we know that there is much more to do.”

New chemical compound ‘stops common cold in its tracks’

It’s a conundrum that has stumped scientists for centuries, but now researchers say they have taken a tantalising step forward in the quest to tackle the common cold.

The scourge of workplace, home and school playground, the common cold is predominantly caused by the rhinovirus. But attempts to thwart the pathogen by vaccination or antiviral drugs face a number of difficulties – not least because the virus comes in many forms and can mutate rapidly leading to drug resistance.

But now scientists say they have discovered a way to nobble the virus that could one day help those with conditions such as asthma and cystic fibrosis, for whom a cold is not merely a nuisance but a serious health risk.

The trick, the authors say, is to develop drugs that interact with one of the enzymes within our cells – an approach that makes it harder for the virus to become drug-resistant.

“Viruses hijack the host to make more copies of themselves. This enzyme is one of the host enzymes that the virus hijacks,” said Roberto Solari, visiting professor at the National Heart and Lung Institute, Imperial College London, and a co-author of the study.

Writing in the journal Nature Chemistry, a team of researchers based around the UK report how they looked at molecules that interact with a human enzyme that attaches a type of fatty acid molecule on to proteins. While two of these molecules on their own had little effect on the enzyme, the team found that when they were chemically stitched together they became remarkably potent in preventing the enzyme from working as normal.

Solari said that is important, since the virus uses the enzyme to assemble the protein coat which surrounds the genetic material of the virus.

“What we found is if we block the addition of this fat, the coat doesn’t assemble so the virus doesn’t package its genes into its coat,” he said. “The virus still makes its own genes, it makes the coat, but the coat can’t assemble so the virus can’t replicate – you actually don’t make infectious particles.”

The team say the molecule appears to completely prevent the virus from replicating, whether it is added one hour before, one hour after or at the same time as the cells are infected, and that it remains effective up to three hours after infection. The approach was also found to prevent the replication of other viruses in the same family as rhinovirus – including polio and foot-and-mouth disease.

But Solari said a cure for the common cold is a long way off: the drug will need to undergo further developments and optimisation before it can be used as a medication, while tests have so far only been carried out on human cells in a dish.

“We haven’t done any animal studies, and we obviously haven’t done any studies in humans, so I can’t tell you formally what the animal toxicity of this compound is,” said Solari, adding that it is also unclear whether the approach would work by the time symptoms of a cold appear – typically a few days after infection. “There is a still a long way before this becomes a medicine,” he said.

And, even if the latest discovery does eventually lead to a way to treat colds, its use is likely to be limited to those with respiratory conditions such as asthma, chronic obstructive pulmonary disease and cystic fibrosis, for whom a catching a cold can be dangerous.

“Rhinovirus, the common cold virus, in healthy people is pretty trivial – you have the runny nose, you have a bit of a temperature, you don’t feel well for two or three days, but you get over it,” said Solari.

London mayor to ban junk food ads on tubes and buses

Junk food adverts are to be banned from London’s tube and bus network by Sadiq Khan, the city’s mayor, in an attempt to curb an epidemic of childhood obesity.

Ads that promote foods and drinks that are high in salt, fat and sugar will no longer be accepted on tubes, buses and overground trains that are part of the Transport for London (TfL) network – nor in stations. The ban is currently out to consultation.

Although adverts for full-sugar Coca-Cola would no longer be accepted under the plans, Diet Coke ads could still run. McDonald’s will be unable to advertise a Big Mac and fries but could promote its salads.

Khan’s announcement was welcomed by obesity campaigners who are pressing for Theresa May’s government to toughen up its child obesity strategy. The national plan omitted measures to curb junk food advertising seen by children online and during family TV shows such as The X Factor.

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Child obesity in London, the mayor said, “is a ticking timebomb”. Almost 40% of 10- and 11-year-olds in London are obese – one of the highest rates in Europe.

Khan challenged the government to do more to stop the obesity epidemic. “If we don’t take bold steps against it we are not doing right by our young people as well as placing a huge strain on our already pressurised health service in years to come,” he said.

“It can’t be right that in a city as prosperous as London that where you live and the income you have can have a massive impact on whether you have access to healthy, nutritious food and your exposure to junk food advertising.

“I’m determined to do all I can to tackle this issue with the powers I have and help Londoners make healthy food choices for themselves and their families.”

The removal of adverts for unhealthy foods would help parents, he said. “I want to reduce the influence and pressure that can be put on children and families to make unhealthy choices.

“The government needs to step up and join this fight against child obesity, so we can achieve real progress – not just in London, but across the entire country.”

Khan is one of a number of mayors taking action in their cities. Amsterdam, as the Guardian revealed last year, has managed to bring down childhood obesity levels by 12% since 2012 through a comprehensive strategy targeted at the poorest families. This year it has brought in its own advertising ban.

Professor Dame Sally Davies


The chief medical officer for England, Sally Davies: ‘The evidence is clear that … restricting the amount of junk food adverts children are exposed to will help reduce obesity.’ Photograph: Ben Stansall/AFP/Getty Images

Michael Bloomberg, the former mayor of New York, is supporting a healthy cities partnership through his own philanthropic foundation, which encourages mayors to take action against tobacco and sugar consumption. London is one of the partners. While mayor of New York, Bloomberg famously tried to ban supersize sugary drinks. He won huge publicity for the public health initiative although he was overruled by the New York supreme court.

Bloomberg, now the World Health Organisation’s global ambassador for noncommunicable diseases, applauded London’s proposed advertising ban. “Obesity has become a global epidemic, and children face a lifetime of health problems unless we take bolder steps to confront it,” he said. “This policy by Mayor Khan sets a great example that other cities can learn from.”

England’s chief medical officer, Professor Dame Sally Davies, was also enthusiastic. “The evidence is clear that, although it is not a silver bullet, restricting the amount of junk food adverts children are exposed to will help reduce obesity,” she said.

“Children are inundated with adverts for unhealthy food so this is a really encouraging move and a bold step in the right direction.”

Food and drink advertising contributed about £20m in revenue to TfL in 2016/17 – around two-thirds of it for food and drink that was high in fat, salt and sugar. But London will probably not lose out financially in the long term. A large proportion of the ads come from big companies that may be persuaded to spend their money on ads for healthier products, such as water or fruit options.

In December last year, Khan proposed a ban on new hot food takeaways opening within 400 metres of schools. His plans are part of the London Food Strategy, which is currently out to consultation.

Chef and campaigner Jamie Oliver called on the government to do more in the imminent next phase of its obesity plan. “This surely must give Mrs May and her cabinet inspiration to do the right thing, be bold, be clear, and pull every lever they can to protect all British kids. Now is the time!” he said.

Cancer Research UK also called for government action, pointing out that obese children can become obese adults with an increased risk of cancer. In the UK, 22,800 cancer cases a year are due to being overweight. “Cancer Research UK wants to see a ban on junk food TV adverts before 9pm in the upcoming obesity strategy so that more young people can be protected from the marketing tactics used by the food industry. And we believe the government should act on this,” said Alison Cox, director of cancer prevention at the charity.

UK universities call for joined-up mental health care for students

Mental health services are failing to adequately support students when they leave home and move to university, allowing them to fall through the gaps at a time of increased vulnerability and stressful new pressures, according to research.

With suicide rates among students on the rise and a sharp increase in demand for mental health support – as much as three-fold in some institutions – universities have acknowledged in a report that current services are letting students down.

The Universities UK report, Minding Our Future, states that the number of students dropping out with mental health problems has more than trebled in recent years and several universities in the UK have seen a number of student suicides over a short period of time.

It calls for urgent action involving a partnership of national and local government, schools, colleges, the NHS and universities, to work together to “join up” mental health care services for students to ensure that a generation of young people are not failed.

UUK is the representative body for UK universities. Its report says one of the key challenges is the transition from services students have depended on at home to a new city, and the transfer of records from one service to another. It also calls for improved links between local NHS services and the support that universities provide.

Student accounts included in the report illustrate the difficulties they face. “After I was discharged I had no mental health or GP support while I was back during the holidays,” said one undergraduate. “Since I was home for four weeks at Christmas and another four at Easter, this was a problem.”

“There always seems to be a lag in transferring records between GPs and my records have been misplaced more than once,” said another.

“Quick access to mental health services is a problem,” said another student. “Referrals take a long time; talking therapies take much, much longer. In the interim, students are missing classes, falling behind with coursework and needing help. The impact on grades can be huge.”

Almost half of all school leavers now go on to university, reflecting the diversity of the wider population, and with 75% of all mental illness developing by the age of 24, the report says university can be a time of acute vulnerability as students grapple with the new challenges of independent learning and living.

Student suicides have steadily increased from 108 in 2001 to 134 in 2015, with a 15-year low in 2007 of 75. There are currently 2.3 million students studying in UK universities.

Professor Steve West, the vice-chancellor of University of the West of England Bristol and chair of UUK’s mental health in higher education advisory group, said: “The system of mental health care for students must be improved. Health services aren’t properly designed to help students as they move from home to university. This is too important to ignore and we must not fail a generation by not doing what is required.

“I call on national and local government, schools, colleges, the health service, voluntary organisations and universities to work together. This will give us the best chance of supporting students through the significant transitions they face during their early lives.”

Paul Jenkins, the chief executive of the Tavistock and Portman NHS trust, added: “We need to improve the links between local NHS services and the support that universities provide. It requires a partnership approach at the local level to assess needs and to design and deliver services for students.

“It is essential that these young people are provided with the right support at each step of the pathway.”

  • In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is 13 11 14. Other international suicide helplines can be found at www.befrienders.org.

NHS will no longer have to share immigrants’ data with Home Office

Ministers have suspended controversial arrangements under which the NHS shared patients’ details with the Home Office so it could trace people breaking immigration rules.

The government’s U-turn on a key element of its “hostile environment” approach to immigration came after MPs, doctors’ groups and health charities warned that the practice was scaring some patients from seeking NHS care for medical problems.

Margot James, a minister in the Department for Digital, Culture, Media and Sport, announced the rethink during a parliamentary debate on the data protection bill. She confirmed that the government had decided to suspend “with immediate effect” the memorandum of understanding (MOU) under which NHS Digital, the health service’s statistical arm, shared 3,000 NHS patients’ details with the Home Office last year so they could check those people’s immigration status. Patients had given their details when attending GP and hospital appointments.

In future, Home Office immigration staff would only be able to use the data-sharing mechanism to trace people who are being considered for deportation from Britain because they have committed a serious crime, James made clear to MPs.

James paved the way for the U-turn by accepting an amendment, tabled by Conservative MP Sarah Wollaston and Labour MP Paul Williams, which called for the MOU to be suspended.

Williams, who is also a GP, welcomed “this huge U-turn”, adding: “NHS information should only be shared in the event of a conviction or an investigation for a serious crime, not to create a hostile environment where people are afraid to go to their GPs for fear information might be reported to the Department for Work and Pensions for benefit sanctions.”

The government backtracked after MPs on the Commons health and social care select committee twice called in unusually strong terms, in January and April, for data-sharing to stop. During evidence on the MOU’s impact it heard how one pregnant woman did not seek any antenatal care because she was too frightened to attend appointments. NHS staff only found out that she was expecting when she turned up at hospital already in labour. Another woman, a migrant domestic worker, died after not seeking treatment for a persistent cough, the committee heard.

Doctors of the World, a London-based charity that provides free healthcare for refugees, asylum-seekers and other undocumented migrants, welcomed the move. “For too long the Home Office has undermined doctor-patient trust and caused unnecessary fear and harm to people most in need of help. Our volunteer doctors saw every day the damage this deal was doing to people in vulnerable situations, including victims of trafficking and pregnant women”, said Lucy Jones, its director of programmes.

Deborah Gold, chief executive of the National Aids Trust (NAT), said: “We are delighted that at last this shameful sharing of confidential patient information with the Home Office is to end.” However, the NAT and Liberty, the civil rights group, both voiced concern about the “vague” definition of serious crimes that the Home Office will use when still pursuing personal details.

Critics warned that passing patients’ details on to the Home Office risked turning NHS staff into de facto immigration officers, was ruining patients’ relationships with NHS personnel and deterring some people from accessing NHS care.

The select committee called for the MOU to be scrapped because it is unethical and damaged patients’ trust in the NHS. Williams, a member of the committee, had previously warned that people left afraid to access care because of data-sharing posed a risk to public health through conditions such as tuberculosis going untreated and children not receiving vital vaccinations.

The Home Office said: “After careful consideration of the concerns raised by the health and social care select committee, the circumstances in which the Home Office will request data from the NHS has changed with immediate effect.

“The changes mean that data will be requested to locate foreign national offenders we intend to deport who have been given a prison sentence of 12 months or more and others who present a risk to the public.

“We remain committed to tackling illegal immigration and will continue to trace immigration offenders using a range of different investigative measures.”

The U-turn comes amid growing concern that staff in some public services, including teachers, housing officials and NHS workers, are being turned into border guards because of new duties put on them to check the immigration status of people they encounter. For example, hospital trusts have been obliged since last October to check that patients are eligible to receive many, but not all, types of care for free and demand that those deemed ineligible pay for their treatment in advance.

In March, the Guardian revealed that the NHS’s Royal Marsden cancer hospital in London had told a Jamaican-born London man who had lived in the UK for 44 years to pay £54,000 upfront before he could undergo radiotherapy to treat his prostate cancer. Sylvester Marshall, who was previously known as Albert Thompson, is now due to receive his treatment free on the NHS.

The British Medical Association, which has also voiced deep unease about sharing of patients’ data, had also called for James to accept the Williams-sponsored clause. The MOU “falls short of the well-established ethical, professional and legal standards for confidentiality”, it said.

The Health and Social Care Act 2012 allowed for patients’ details, which they had provided confidentially to the NHS, to be used to help trace immigration offenders. It led to the signing of the MOU between NHS Digital, the Home Office and the Department of Health. Last year it led to more than 3,000 patients having their details passed to the Home Office for its immigration purposes. Of those, 195 requests for data led to the Home Office finding out new information about people.

Meanwhile, Jeremy Hunt, the health and social care secretary, has come close to backing calls from leading doctors and Labour for NHS staff to be exempted from the monthly cap on the number of skilled workers from overseas who are allowed to come to the UK.

Having a separate system of visas for doctors and nurses, he said, was “a really interesting idea” that he will discuss with Sajid Javid, the home secretary. The cap has led to 400 doctors being denied permission to join the NHS since December, despite having job offers from hospitals, because the cap had been reached.

“It’s invidious when the NHS gets traded off against other sectors in the economy,” Hunt told the Health Service Journal.

NHS will no longer have to share immigrants’ data with Home Office

Ministers have suspended controversial arrangements under which the NHS shared patients’ details with the Home Office so they can trace people breaking immigration rules.

The government’s U-turn on a key element of its “hostile environment” approach to immigration came after MPs, doctors’ groups and health charities warned that the practice was scaring some patients from seeking NHS care for medical problems.

Margot James, a minister in the Department for Digital, Culture, Media and Sport, announced the rethink during a parliamentary debate on the data protection bill. She confirmed that the government had decided to suspend “with immediate effect” the memorandum of understanding (MOU) under which NHS Digital, the health service’s statistical arm, shared 3,000 NHS patients’ details with the Home Office last year so they could check those people’s immigration status. Patients had given their details when attending GP and hospital appointments.

In future, Home Office immigration staff would only be able to use the data-sharing mechanism to trace people who are being considered for deportation from Britain because they have committed a serious crime, James made clear to MPs.

James paved the way for the U-turn by accepting an amendment, tabled by Conservative MP Sarah Wollaston and Labour MP Paul Williams, which called for the MOU to be suspended.

Williams, who is also a GP, welcomed “this huge U-turn”, adding: “NHS information should only be shared in the event of a conviction or an investigation for a serious crime, not to create a hostile environment where people are afraid to go to their GPs for fear information might be reported to the Department for Work and Pensions for benefit sanctions.”

The government backtracked after MPs on the Commons health and social care select committee twice called in unusually strong terms, in January and April, for data-sharing to stop. During evidence on the MOU’s impact it heard how one pregnant woman did not seek any antenatal care because she was too frightened to attend appointments. NHS staff only found out that she was expecting when she turned up at hospital already in labour. Another woman, a migrant domestic worker, died after not seeking treatment for a persistent cough, the committee heard.

Doctors of the World, a London-based charity that provides free healthcare for refugees, asylum-seekers and other undocumented migrants, welcomed the move. “For too long the Home Office has undermined doctor-patient trust and caused unnecessary fear and harm to people most in need of help. Our volunteer doctors saw every day the damage this deal was doing to people in vulnerable situations, including victims of trafficking and pregnant women”, said Lucy Jones, its director of programmes.

Deborah Gold, chief executive of the National Aids Trust (NAT), said: “We are delighted that at last this shameful sharing of confidential patient information with the Home Office is to end.” However, the NAT and Liberty, the civil rights group, both voiced concern about the “vague” definition of serious crimes that the Home Office will use when still pursuing personal details.

Critics warned that passing patients’ details on to the Home Office risked turning NHS staff into de facto immigration officers, was ruining patients’ relationships with NHS personnel and deterring some people from accessing NHS care.

The select committee called for the MOU to be scrapped because it is unethical and damaged patients’ trust in the NHS. Williams, a member of the committee, had previously warned that people left afraid to access care because of data-sharing posed a risk to public health through conditions such as tuberculosis going untreated and children not receiving vital vaccinations.

The Home Office said: “After careful consideration of the concerns raised by the health and social care select committee, the circumstances in which the Home Office will request data from the NHS has changed with immediate effect.

“The changes mean that data will be requested to locate foreign national offenders we intend to deport who have been given a prison sentence of 12 months or more and others who present a risk to the public.

“We remain committed to tackling illegal immigration and will continue to trace immigration offenders using a range of different investigative measures.”

The U-turn comes amid growing concern that staff in some public services, including teachers, housing officials and NHS workers, are being turned into border guards because of new duties put on them to check the immigration status of people they encounter. For example, hospital trusts have been obliged since last October to check that patients are eligible to receive many, but not all, types of care for free and demand that those deemed ineligible pay for their treatment in advance.

In March, the Guardian revealed that the NHS’s Royal Marsden cancer hospital in London had told a Jamaican-born London man who had lived in the UK for 44 years to pay £54,000 upfront before he could undergo radiotherapy to treat his prostate cancer. Sylvester Marshall, who was previously known as Albert Thompson, is now due to receive his treatment free on the NHS.

The British Medical Association, which has also voiced deep unease about sharing of patients’ data, had also called for James to accept the Williams-sponsored clause. The MOU “falls short of the well-established ethical, professional and legal standards for confidentiality”, it said.

The Health and Social Care Act 2012 allowed for patients’ details, which they had provided confidentially to the NHS, to be used to help trace immigration offenders. It led to the signing of the MOU between NHS Digital, the Home Office and the Department of Health. Last year it led to more than 3,000 patients having their details passed to the Home Office for its immigration purposes. Of those, 195 requests for data led to the Home Office finding out new information about people.

Meanwhile, Jeremy Hunt, the health and social care secretary, has come close to backing calls from leading doctors and Labour for NHS staff to be exempted from the monthly cap on the number of skilled workers from overseas who are allowed to come to the UK.

Having a separate system of visas for doctors and nurses, he said, was “a really interesting idea” that he will discuss with Sajid Javid, the home secretary. The cap has led to 400 doctors being denied permission to join the NHS since December, despite having job offers from hospitals, because the cap had been reached.

“It’s invidious when the NHS gets traded off against other sectors in the economy”, Hunt told the Health Service Journal.